H.B. No. 412 aims to enhance health benefit plan coverage for early childhood intervention services in Texas. The bill amends the Insurance Code to include a broader range of rehabilitative and habilitative therapies, specifically adding dietary or nutritional evaluations, specialized skills training by certified early intervention specialists, applied behavior analysis treatment by licensed professionals, and case management services. Additionally, it clarifies that health benefit plans must provide coverage that complies with the new requirements and cannot impose annual or lifetime limits on these therapies, except for specialized skills training, which may be subject to a $9,000 annual cap.

The bill also establishes that health benefit plans must cover services specified in a child's individualized family service plan without imposing prior authorization requirements. It ensures that children must exhaust their coverage under this section before accessing state-provided benefits for early childhood intervention services, maintaining the obligations of the state and federal government under the Individuals with Disabilities Education Act. The provisions of this bill will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, with the act taking effect on September 1, 2025.

Statutes affected:
Introduced: Insurance Code 1367.201, Insurance Code 1367.202, Insurance Code 1367.204, Insurance Code 1367.205, Insurance Code 1367.206 (Insurance Code 1367)